Changes in Hair Color

Poliosis, hair pigment dilution, and premature graying of the hair: A diagnostic approach in pediatric patients and review of the literature

Poliosis is defined as the absence of melanin in hair, and hair graying typically occurs with hair melanin reduction. Poliosis can occur at any age but presents in childhood in certain genetic and acquired conditions, with many families seeking evaluation from a pediatric dermatologist. Poliosis presents as white hair typically restricted to a certain location of the scalp. Children may also present with a reduction of expected hair pigmentation, referred to as pigment dilution, or the development of hair graying. This review aims to provide a streamlined diagnostic approach for pediatric dermatologists when presented with these hair findings. Poliosis should be recognized as a potential diagnostic feature or initial sign in many syndromes and thus can guide clinicians in diagnosing and managing conditions earlier in a patient's care. Since many of the genetic and acquired conditions that present with poliosis or hair pigment dilution have extracutaneous manifestations, early diagnosis is vital in establishing multidisciplinary care.

The surface and internal features of pubic hair: A comparative study with those of scalp hair

Although pubic hair has been a subject of public interest, little is known about its structure or characteristics beyond its curly and coarse appearance. In this study, we investigated the surface and internal features of pubic hair from Korean males and compared them to those of scalp hair from the same donors. Our findings indicate that the cuticle layer of pubic hair has a greater number of scales than that of scalp hair, resulting in a thicker cuticle layer overall. Fourier-transform infrared (FT-IR) spectroscopy analysis showed that the protein in the cortex layer of pubic hair was less affected by exposure to urine or ammonia than the protein in the cortex layer of scalp hair. This suggests that the cuticle layer of pubic hair, which is thicker and composed of more scales, acts as a physical barrier that protects the hair's internal structure. Furthermore, we observed that the secondary and tertiary structures of keratin in the pubic hair cuticle layer are essentially different from those in scalp hair. Based on these findings, we hypothesize that the thickened cuticle layer in pubic hair may have evolved as a defence mechanism against chemical damage from urine, urea and ammonia.

Trichotemnomania in an Adolescent Girl: A Case Report of an Asian Child and Literature Review

Trichotemnomania (TT) refers to cutting or shaving of one's own hair as a compulsive act. This condition is reported rarely and may be indicative of an underlying obsessive-compulsive disorder. TT may be misdiagnosed with trichotillomania or other disorders such as alopecia areata, tinea capitis, and postinflammatory scars. The diagnosis of trichotemnomania is confirmed by dermoscopic assessment, histopathological changes of hair, and correlation of these findings with clinical history. A fourteen-year-old adolescent girl presented with focal hair loss over forehead for duration of two-weeks and periodic abnormal breathing and poor sleep for 2-month duration. Besides, she had also lost some of pubic hair and hair on the forearm over preceding 24 hours. This patient was assessed by a team including a paediatrician, gynecologist, dermatologist, and psychiatrist to gather focused medical history and to perform physical examination, laboratory investigations, and dermoscopic assessment. It was revealed that she used to shave or cut regularly following stressful situations across various aspects of her life and hyperventilate as a means of relieving her stress. Eventually, she was diagnosed to have trichotemnomania and was started oral sertraline 50 mg/day for one month. Clinical features and her behaviour improved with regular cognitive behavioural therapy, and hairs were demonstrated to grow up normally with change in behaviour. Currently, she does well at school and is off medications and being followed up at the child guidance clinic. Trichotemnomania is a very rare disorder which is characterised by cutting or shaving of one's own hairs as a compulsive habit. The condition needs careful and detailed assessment by a team of specialists to identify coexisting psychiatric disorders and offer treatment.

Types and Treatment of Hair Loss in Men and Women

In this article, the author focuses on 4 common hair loss disorders that occur in both men and women. The author discusses research related to androgenetic alopecia, telogen effluvium, alopecia areata, and scarring alopecia and provides details on how to approach and manage these diseases according to patient gender. There are a range of tools and tests that can assist with the diagnostic process and help ensure that relevant and high standards of patient care are maintained. In some cases, no medical intervention is always a treatment option. However, appropriate medical treatments, although still relatively limited in some cases, are safe and have proven efficacy. Hair loss has immense emotional and psychological impact in both genders, and it is always important to consider this when planning hair loss management pathways.

Types and Treatment of Hair Loss in Men and Women

In this article, the author focuses on 4 common hair loss disorders that occur in both men and women. The author discusses research related to androgenetic alopecia, telogen effluvium, alopecia areata, and scarring alopecia and provides details on how to approach and manage these diseases according to patient gender. There are a range of tools and tests that can assist with the diagnostic process and help ensure that relevant and high standards of patient care are maintained. In some cases, no medical intervention is always a treatment option. However, appropriate medical treatments, although still relatively limited in some cases, are safe and have proven efficacy. Hair loss has immense emotional and psychological impact in both genders, and it is always important to consider this when planning hair loss management pathways.

Medication-Induced Repigmentation of Gray Hair: A Systematic Review

Hair graying is a common sign of aging resulting from complex regulation of melanogenesis. Currently, there is no medical treatment available for hair repigmentation. In this article we review the literature on medication-induced hair repigmentation, discuss the potential mechanisms of action, and review the quality of the literary data. To date, there have been 27 studies discussing medication-induced gray hair repigmentation, including 6 articles on gray hair repigmentation as a primary objective, notably with psoralen treatment or vitamin supplementation, and 21 reports on medication-induced gray hair repigmentation as an incidental finding. Medications noted in the literature include anti-inflammatory medications (thalidomide, lenalidomide, adalimumab, acitretin, etretinate, prednisone, cyclosporin, cisplatinum, interferon-α, and psoralen), stimulators of melanogenesis (latanoprost, erlotinib, imatinib, tamoxifen, and levodopa), vitamins (calcium pantothenate and para-amino benzoic acid), a medication that accumulates in tissues (clofazimine), and a medication with an undetermined mechanism (captopril). Diffuse repigmentation of gray hair can be induced by certain medications that inhibit inflammation or stimulate melanogenesis. There is also low-quality evidence that some vitamin B complex supplementation can promote gray hair darkening. While these compounds are not currently indicated for the treatment of gray hair, their mechanisms shed light on targets for future medications for hair repigmentation.

New Derivatization Methodology of 4-aminobenzoic Acid from its Dietary Supplements: Kinetic Spectrophotometric Methods for Determination

Background:

A new approach describing the validation and development of an easy, new spectrophotometric and kinetic method for identification of para-aminobenzoic acid in dietary supplement has been performed. In this study, para-aminobenzoic acid was derived in a pH-controlled environment, as a new organic compound 4(4-Benzophenylazo)pyrogallol, by incorporating diazotized para-aminobenzoic acid with pyrogallol.

Objective:

The determination of para-aminobenzoic acid was conducted by the fixed time and initial rate techniques. These approaches were based on the reaction of the compound containing paraaminobenzoic acid, 4(4-Benzophenylazo)pyrogallol, with Ag(I) to form colored product with a maximum absorbance at 468nm. Both of these techniques were adopted for constructing the calibration curves and examined for their suitability for the quantitation of para-aminobenzoic acid in dietary supplement.

Methods:

The determination process was established, using initial rate and fixed time kinetic spectrophotometric methods.

Results:

4(4-Benzophenylazo)pyrogallol was characterized using proton-nuclear magnetic resonance, Fourier-transform infrared, differential scanning calorimetry and thermogravimetric thermal methods, gas chromatography–mass techniques, and solvatochromic behavior in solvents with different polarities was also examined.

Conclusion:

For the first time, para-aminobenzoic acid was well determined by incorporating it as an organic solid compound, 4(4-Benzophenylazo)pyrogallol, through coupling pyrogallol with diazotized para-aminobenzoic acid in regulated pH medium, ranging between 5.0 to 6.0. The existence of common excipients in the dietary supplement did not produce any significant interference. F- and ttest data analysis were used for statistical comparison of the suggested techniques with that of reference method, demonstrating excellent agreement with no significant difference in the associated precision and accuracy.

A variety of processes that affect the perception of skin aging

The purpose of this paper is to discuss the most important factors affecting perceived age. Aging is an unavoidable and irreversible process, but perceived age is a modifiable psychosocial factor. Our exterior has become one of the determinants of our social position, the key to success in our professional and personal lives. Today, we see people through their appearance, we judge after the first impression. With the help of aesthetic medicine, we can change the perceived age, but we cannot stop aging. This article discusses factors affecting the perceived age, such as hair color, skin color, general appearance and environmental factors. Many cannot be avoided, but we can make changes in life to look younger and more well-groomed. Indeed, we can change our habits for the benefit of the whole body, not only for the skin.

Description and characterization of a hair coat disorder in schipperkes

BACKGROUND

Schipperkes develop bilaterally symmetrical alopecia preceded by lightening of the hair coat not associated with systemic clinical signs. The alopecia is presumptively diagnosed as Alopecia X but has never been investigated.

HYPOTHESIS/OBJECTIVES

The purpose of this study was to describe clinical features, histopathological and laboratory abnormalities associated with symmetrical, noninflammatory alopecia in schipperkes.

ANIMALS

Three healthy and eight affected schipperkes.

METHODS AND MATERIALS

Complete blood count (CBC), serum chemistry panel, urinalysis (UA), urine cortisol: creatinine ratio (UCCR), total thyroxine (T₄ ), free thyroxine by equilibrium dialysis (fT₄ ed), thyroid stimulating hormone (TSH) and pre- and post-stimulation cortisol with sex hormone analyses were performed for all dogs. A minimum of two skin biopsy sites were sampled for histopathological evaluation.

RESULTS

The CBC, serum chemistry panel, UA, T₄ , fT₄ ed, TSH and post-ACTH cortisol concentrations were normal for all dogs. Androstenedione concentrations were increased for all dogs; two of three healthy and five of eight affected dogs had increased post-ACTH androstenedione concentrations. Estradiol concentrations were increased for all healthy and four of eight affected dogs, with post-ACTH estradiol concentrations increased for all healthy and five of eight affected dogs. Progesterone concentrations were increased for two of three healthy and four of eight affected dogs. Post-ACTH progesterone concentrations were increased for one of three healthy and four of eight affected dogs. For one of three healthy and two of eight affected dogs, 17-hydroxyprogesterone concentrations were increased; post-ACTH 17-hydroxyprogesterone concentrations were increased in three of eight affected dogs only. Histopathology results from affected dogs were consistent with hair cycle arrest.

CONCLUSIONS AND CLINICAL IMPORTANCE

This disorder resembles Alopecia X clinically and histologically.

Age Estimation Based on Appearance of Gray Hair in Different Body Sites of Sri Lankan Autopsy Cases

Owing to the scanty evidence on usefulness of information of appearance of gray hair for age estimation, this study was conducted to estimate age based on the appearance of gray hair on different body sites in a sample of autopsy cases in Sri Lanka. A descriptive cross-sectional study was conducted in Teaching Hospital-Kurunegala during 2011 to 2013. Based on the pattern of the presence of gray hair in different body sites, six stages of gray hair were computed. The analysis 1155 autopsy cases revealed strong, positive correlations between age and appearance of gray hair in head, mustache, beard, and pubic area among males and strong, positive correlations between age and the appearance of gray hair in head and pubic area among females (p < 0.01). Our findings demonstrate the value of information of appearance of gray hair for age estimation in the field of forensic science.

The pattern of hair dyeing in koreans with gray hair

Background

Hair graying is considered as a part of normal ageing process. Nonetheless, this process raises a significant cosmetic concern, especially among ethnic Korean elderly whose baseline hair color is black. For this reason, Korean elderly dye their hair with frequency despite the risk of dermatologic problems such as allergic contact dermatitis.

Objective

In this study, the authors investigate the prevalence and pattern of hair dyeing and its relation with scalp diseases in Korea.

Methods

Six hundred twenty subjects (330 men and 290 women) with graying hair were given a questionnaire survery and underwent a physical examination.

Results

Of the 620 total, 272 subjects (43.9%) dyed their hair. Hair dyeing was significantly more frequent among women than among men (p<0.001). Subjects from 50 to 69 years of age showed higher prevalence of hair dyeing when compared to either younger or older groups. Subjective self-assessment of the extent of hair graying was associated with increased prevalence of hair dyeing, that is, individuals who feel graying has advanced by more than 20% of the overall hair were much more likely to dye their hair (p<0.001). Hair dyeing did not correlate with either alopecia or scalp disease.

Conclusion

Our survey has found that the prevalence of hair dyeing is higher among Korean women than men. People in their fifties and sixties and people with more than 20% extent of grayness were more likely to dye their hair than otherwise. Hair dyeing was not associated with any increase in the prevalence of scalp diseases.

Efficacy and Safety of Pueraria lobata Extract in Gray Hair Prevention: A Randomized, Double-Blind, Placebo-Controlled Study

Background

Graying of hair-a sign of aging-raises cosmetic concerns. Individuals with gray hair often look older than others their age; therefore, some dye their hair for aesthetic purposes. However, hair colorants can induce many problems including skin irritation, allergic reaction and hair-breakage.

Objective

This randomized, double-blind clinical trial was performed in order to examine the effects of APHG-1001, a compound including an extract from Pueraria lobata, on graying hair.

Methods

A total of 44 female subjects were randomly treated with either APHG-1001 or placebo twice daily for 24 weeks. Using the phototrichogram analysis, a count of newly developed gray hair was estimated. Investigator assessment and subject self-assessment were also performed in order to evaluate the efficacy of the compound.

Results

The mean number of newly developed gray hair at 24 weeks was 6.3/cm² in the APHG-1001 group and 11.4/cm² in the placebo group; the difference was statistically significant (p<0.05). However, the investigator assessment and subject self-assessment did not show any significant change in the gross appearance of hair grayness by the end of the study. No severe adverse events in either group were observed. Moreover, the incidence of adverse events did not differ between the groups.

Conclusion

This clinical trial revealed that APHG-1001, which contains an extract of P. lobata, could prevent the development of new gray hair without any remarkable adverse effects. Thus, it can be considered as a viable treatment option for the prevention of gray hair.

Serum iron, zinc, and copper concentration in premature graying of hair

Premature graying of hair with unclear etiology, which is known as premature canities, is a common cause of referrals to the dermatologists. We assessed the relationship between serum iron, copper, and zinc concentrations with premature canities. This study was conducted on patients under 20 years old suffering from premature canities, having a minimum of ten gray hair fibers, and referring to university hospitals of Isfahan (Iran). The results were compared with age-sex-matched controls. Demographic data and disease characteristics were recorded for two groups. We studied serum iron, copper, and zinc concentrations of 66 patients and 66 controls using atomic absorption and Ferrozine methods. The mean age of studied cases was 17.8 ± 2.0 years, and the mean age of the onset of canities was 15.5 ± 3.2 years with no significant difference between males and females (P > 0.05). Serum copper concentration was significantly lower in patients compared with controls (90.7 ± 37.4 vs. 105.3 ± 50.2 μg/dL, P = 0.048), but serum iron concentration was significantly lower in controls compared to patients (88.8 ± 39.5 vs. 108.3 ± 48.4 μg/dL, P = 0.008). Also, there was no significant difference between patients and controls in serum zinc concentration (114.8 ± 67.8 vs. 108.2 ± 49.9 μg/dL, P = 0.285). According to these results, among copper, zinc, and iron, a low serum copper concentration may play a role in premature graying of hairs in our society. Further studies are needed to find the underlying mechanism of this relationship.

Childhood malnutrition is associated with a reduction in the total melanin content of scalp hair

Childhood malnutrition is known to be associated with visible lightening of hair colour (hypochromotrichia). Nevertheless, no systematic investigations have been carried out to determine the biochemical basis of this change. We used an HPLC method to measure melanins in the scalp hair of thirteen Jamaican children, diagnosed as having primary malnutrition, during various stages of their treatment and after recovery. During treatment for malnutrition, a progressive decrease in total melanin content along the hair shaft from tip to root (root:tip ratio: 0·62 (sd 0·31)) was observed. This ratio was significantly different (P = 0·003) from the ratio observed among children sampled several months after discharge from hospital (0·93 (sd 0·23)) and among normal control children (0·97 (sd 0·12)). Thus, it appears that a decrease in melanin content is associated with periods of malnutrition. The low root:tip ratio during malnutrition presumably arises because the tips reflect prior hair growth during ‘normal’ nutrition and the roots reflect hair growth during malnutrition; a return of the root:tip ratio to that seen among controls reflects ‘recovery’ from malnutrition. It is possible that reduced intake or availability of tyrosine, a key substrate in melanin synthesis, may play a role in the reduction of hair melanin content during periods of malnutrition. The precise mechanisms by which melanin content is reduced, and the role of aromatic amino acid availability in hair colour change and other features of childhood malnutrition remain to be explored.

Alopecia areata

Alopecia areata (AA) is a nonscarring, autoimmune, inflammatory, hair loss on the scalp, and/or body. Etiology and pathogenesis are still unknown. The most common site affected is the scalp. Histopathology is characterized by an increased number of the catagen and telogen follicles, the presence of inflammatory lymphocytic infiltrate in the peribulbar region ("swarm of bees"). Corticosteroids are the most popular drugs for the treatment of this disease. Etiologic and pathogenic mechanisms, as well as other current treatments available will be discussed in this article.

Heterochromia of the scalp hair: a result of pigmentary mosaicism?

Five patients who presented stable bands of hair of a different color with respect to the surrounding hair are reported. In 4 patients this was an isolated finding. One patient also had diffuse linear skin hypopigmentation and other abnormalities. We hypothesize that these 5 cases represent a distinct type of hair heterochromia, possibly because of somatic mosaicism for genes affecting pigmentation.

Premature hair greying may predict reduced bone mineral density in Graves' disease

BACKGROUND

Premature hair greying has been associated with low bone mineral density (BMD), and it may be more frequent in Graves' disease.

AIMS

To determine whether premature greying is associated with reduced BMD in women with Graves' disease and in control women, and to examine whether premature greying is more common in Graves' disease.

METHODS

Premature greying (> 50% grey by 40 years) and BMD were determined in 44 women with a history of Graves' disease and 133 female controls referred for routine BMD measurement. Exclusion criteria included diseases or drugs known to affect BMD.

RESULTS

Mean Z and T scores at the lumbar spine were significantly lower (P < 0.04) in subjects with premature greying than in those not prematurely grey among women with Graves' disease, but not among control women. Multiple regression confirmed this difference between Graves' and control women (P = 0.041). There were no differences at other measurement sites. Of Graves' patients, 36% were prematurely grey compared with 25% of control women (P = 0.14).

CONCLUSION

Premature greying may be a weak marker for reduced BMD in women with a history of Graves' disease, but it is not a marker in normal women.

Effect of low levels of dietary tyrosine on the hair colour of cats

Experiments were conducted to investigate the basis for the change in hair colour of black cats to reddish-brown. Black cats were given purified diets based on gelatin, casein plus lactalbumin, or crystalline amino acids as protein sources. Diets that caused the colour of hair to change to reddish-brown were associated with a reduction in melanin in hair (observed by direct microscopic examination), a decreased total melanin concentration and low concentrations of tyrosine in plasma. Reddish hair coat was induced in black kittens born to queens given a tyrosine-deficient diet during pregnancy. Black hair colour was maintained or restored by diets containing a high concentration of tyrosine or phenylalanine. Current dietary recommendations for dietary tyrosine and phenylalanine for cats are below those required to support maximal melanin synthesis in black cats. The requirement appears to be greater than a combination of 4.5 g tyrosine plus 12 g phenylalanine/kg diet but less than 24 g phenylalanine alone/kg diet.

Migratory poliosis: A forme fruste of alopecia areata?

We describe a 19-year-old African-American man with a 14-year history of migratory poliosis. We suggest that this phenomenon may represent a forme fruste of alopecia areata.

Drug-induced hair colour changes

Drug-induced hair colour changes are not a common adverse effect from medications. A wide variety of drugs have been implicated in causing hair colour changes but very few have data to support a true relationship. Of the drugs reported, chloroquine and cancer chemotherapeutic agents have the best evidence to support an association. Other drugs, such as p-aminobenzoic acid, calcium pantothenate, anthralin, chinoform, mephenesin, minoxidil, propofol, valproic acid, and verapamil await confirmatory data. Drug-induced causes should be considered in any patient with unexplained hair colour changes.

Evidence for alpha-MSH binding sites on human scalp hair follicles: preliminary results

Alpha-MSH, considered an important pigmentation hormone, binds to melanocytes and is thought to stimulate melanogenesis through a cyclic-AMP-dependent mechanism. The binding of alpha-MSH to follicular melanocytes has been investigated in human hair of different colors, ranging from black to blond and senile white. Hairs were plucked, the follicles were cut off, and an alpha-MSH binding assay, using a radiolabeled alpha-MSH analogue, was performed on these bulbs. As controls of each assay, fragments of hairs of the same person were used. The results show a dose-response relationship and the assay seems to be specific for alpha-MSH, because other peptides such as ACTH, beta-LPH and beta-endorphins do not compete for binding sites as alpha-MSH does. These binding sites seem to be present only on melanin synthesizing melanocytes, since the controls and follicles of senile white hair, which do not contain active melanocytes, show negative results. All the assays were performed on raw material, i.e., whole plucked hair follicles. This is the first time that binding sites for alpha-MSH have been demonstrated on human scalp hair follicles. In addition, their presence was found to be associated with active melanin production; their absence was demonstrated on senile white hair follicles.